Meyer dysplasia

Case contributed by Dr Jeremy Jones

Presentation

Atraumatic right hip pain. No red flag signs or symptoms. Pain on movement of the right hip and reduced range of motion.

Patient Data

Age: 2 years
Gender: Male
X-ray

Sclerosis and flattening of the right femoral epiphysis. Otherwise normal appearance. The child is very young for avascular necrosis, but that is in the differential along with Meyer dysplasia.

X-ray

Follow up 1 year later

In 1 year, there has been very little change and there is no fragmentation. The ossification of the femoral head is atypical with nodularity. Features are more in keeping with Meyer dysplasia.

Case Discussion

A small, dense femoral epiphysis should always make you think of avascular necrosis (Perthes disease if idiopathic). However, where there is no change, and the femoral head as an apparent nodularity to the ossification, Meyer dysplasia is a good differential.

The nodularity of ossification is sometimes termed "morulated" which derives from cleavage and separation in embryology but is rarely used in clinical practice.

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Case information

rID: 66207
Published: 11th Feb 2019
Last edited: 2nd Mar 2019
System: Paediatrics
Inclusion in quiz mode: Included
Institution: NHS Lothian

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